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Pertussis (Whooping Cough) – What You Need To Know

Pertussis (whooping cough) is a very contagious disease caused by a type of bacteria called Bordetella pertussis. Among vaccine-preventable diseases, pertussis is one of the most commonly occurring ones in the United States.

As of November 16, 2012, more than 35,000 cases have been reported across the United States, including 16 deaths. The majority of deaths continue to occur among infants younger than 3 months of age. Learn more about pertussis outbreaks and trends.

Pertussis Vaccine Protection

There is high pertussis vaccine coverage for children nationwide. However, protection from the childhood vaccine decreases over time. Preteens, teens and adults need to be revaccinated, even if they were completely vaccinated as children.

Also, pertussis vaccines are very effective but not 100% effective [PDF - 140KB]. If pertussis is circulating in the community, there is still a chance that a fully vaccinated person can catch this very contagious disease. When you or your child develops a cold that includes a prolonged or severe cough, it may be pertussis. The best way to know is to contact your doctor.

Pertussis Symptoms

Pertussis can cause serious illness in infants, children and adults. The disease starts like the common cold, with runny nose or congestion, sneezing, and maybe mild cough or fever. But after 1–2 weeks, severe coughing can begin.

Unlike the common cold, pertussis can become a series of coughing fits that continues for weeks. Pertussis can cause violent and rapid coughing, over and over, until the air is gone from the lungs and you are forced to inhale with a loud "whooping" sound. In infants, the cough can be minimal or not even there. They may instead have life-threatening pauses in breathing (apnea).

Pregnant? Protect Yourself & Your Baby from Whooping Cough

When the source of whooping cough was identified, mothers were responsible for 30-40% of infant infections 1.

Talk with your doctor about getting the whooping cough booster shot, Tdap, to protect yourself and your baby. Tdap is preferred later in pregnancy to maximize the amount of protective antibodies that pass from you to your baby. Learn more about vaccine protection for pertussis.

If your baby is having trouble breathing, take him to a hospital or doctor right away.

Disease Complications

Pertussis is most severe for babies; more than half of infants younger than 1 year of age who get the disease are hospitalized. About 1 in 4 infants with pertussis get pneumonia (lung infection), and about two thirds will have slowed or stopped breathing. Pertussis can be deadly for 1 or 2 infants per 100 who are hospitalized. Learn how pertussis can be treated.

How Pertussis Spreads

People with pertussis usually spread the disease by coughing or sneezing while in close contact with others, who then breathe in the pertussis bacteria. Many infants who get pertussis are infected by parents, older siblings, or other caregivers who might not even know they have the disease.

Pertussis Trends

Reported cases of pertussis vary from year to year and tend to peak every 3-5 years. In 2011, 18,719 cases of pertussis were reported in the U.S.—and many more cases go unreported. Thirteen deaths were reported – 11 of these deaths were in children younger than 1 year old.

Preventing Pertussis

The best way to prevent pertussis is to get vaccinated. Parents can also help protect infants by keeping them away as much as possible from anyone who has cold symptoms or is coughing.

Vaccine Recommendations

For Infants and Children: In the US, the recommended pertussis vaccine for children is called DTaP. This is a safe and effective combination vaccine that protects children against three diseases: diphtheria, tetanus, and pertussis. For maximum protection against pertussis, children need five DTaP shots. The first three shots are given at 2, 4, and 6 months of age. The fourth shot is given at 15 through 18 months of age, and a fifth shot is given when a child enters school, at 4 through 6 years of age. If a 7-10 year old is not up-to-date with DTaP vaccines, a dose of Tdap should be given before the 11-12 year old check up.

For Preteens and Teens: Vaccine protection for pertussis, tetanus, and diphtheria can decrease with time. Preteens should get a booster vaccine, called Tdap, at 11 or 12 years of age. Teens and young adults who didn't get a booster of Tdap as a preteen should get one dose when they visit their health care provider.

Photo: An expecting mother

For Pregnant Women: Expectant mothers should get one dose of Tdap, preferably later in pregnancy. By getting Tdap during pregnancy, maternal pertussis antibodies transfer to the newborn, likely providing protection against pertussis in early life, before the baby starts getting DTaP vaccines. Tdap will also protect the mother at time of delivery, making her less likely to transmit pertussis to her infant. If not vaccinated during pregnancy, Tdap should be given immediately postpartum, before leaving the hospital or birthing center.

For Adults: Adults 19 years of age and older who didn't get Tdap as a preteen or teen should get one dose of Tdap. Getting vaccinated with Tdap at least two weeks before coming into close contact with an infant is especially important for families with and caregivers of new infants.

Adults get Tdap in place of one of their regular tetanus boosters—the Td shot that is recommended for adults every 10 years. However, the dose of Tdap can be given no matter when the last Td shot was received. It's a good idea for adults to talk to a health care provider about what's best for their specific situation.

More Information

References

1 Bisgard KM, Pascual FB, Ehresmann KR, et al. Infant pertussis: who was the source? Pediatr Infect Dis J. 2004;23:985-89. Wendelboe AM, Njamkepo E, Bourillon A, et al. Transmission of Bordetella pertussis to young infants. Pediatr Infect Dis J. 2007;26:293-99.

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Last syndicated: November 21, 2012
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